电刺激足三里对危重症病人肠内营养并发症的防治作用

The effect of electrical stimulation on complications of enteral nutrition for ICU patients

目的:探讨电刺激足三里穴对危重症病人肠内营养(EN)并发症的防治作用。方法:将ICU中61例行EN的病人随机分为试验组(29例)和对照组(32例)。试验组病人在EN的同时给予穴位电刺激;对照组只给予EN治疗。观察两组病人发生误吸、反流、吸入性肺炎、腹泻、消化道出血等并发症的情况,并每天测定病人胃黏膜的二氧化碳分压(PgCO2)和pH值(pHi)以及胃潴留量和喂养量。结果:试验组病人误吸、反流、吸入性肺炎、腹泻、消化道出血的发生率明显低于对照组,两组比较有显著性差异(P<0.05);两组病人胃黏膜PgCO2与pHi在第2、3、4、5、6和7天组间比较,试验组胃黏膜PgCO2明显降低、胃黏膜pHi明显升高(P<0.05);试验组胃潴留量明显减少,喂养量明显增加(P<0.05)。结论:应用电刺激足三里穴位治疗,能明显降低EN并发症,使危重症病人的EN支持更为安全有效。

Objective： To observe the effect of electrical stimulation of Zusanli on complications of enteral nutrition for ICU patients.Methods： 61 patients receiving enteral feeding were randomly assigned to either the experimental group or the control groups.The experimental group received enteral nutrition and electrical stimulation.The control group received enteral nutrition only.The complications of vomiting,diarrhea,gastrointestinal bleeding and aspiration pneumonia were observed every day.The PgCO2 and Phi index of gastric mucosa,the volume of enteral feeding and gastric retension were measured every day.Results：The incidence of vomiting,aspiration pneumonia,diarrhea and gastrointestinal bleeding in experimental group were significantly lower than the control group（P0.05）.On treatment day 2-7,the PgCO2 of gastric mucosa decreased and the Phi of gastric mucosa increased in more patients in the experimental group than in the control group（P0.05）.The volume of enteral feeding improved and the gastric residual volume reduced in comparison with the control group（P0.05）.Conclusion： The complications of enteral nutrition can be reduced in the ICU patients who received acupoint stimulation at Zusanli.